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bupropion
Overview
Active ingredients
Source: NDC DirectoryForms, strengths and routes
Source: NDC DirectoryPharmacologic classes are listed in the class section below.
Pharmacologic class
Source: NDC Directory| Class | Type | Browse |
|---|---|---|
| Aminoketone [EPC] | EPC | All 13 members |
| Dopamine Uptake Inhibitors [MoA] | MoA | All 14 members |
| Increased Dopamine Activity [PE] | PE | All 13 members |
| Increased Norepinephrine Activity [PE] | PE | All 17 members |
| Norepinephrine Uptake Inhibitors [MoA] | MoA | All 44 members |
Regulatory status
Source: Drugs@FDANDC Directory| Product | Trade name | Form | Strength | Ingredient | Status | TE | Flags |
|---|---|---|---|---|---|---|---|
| 201567-001 | BUPROPION HYDROCHLORIDE | TABLET, EXTENDED RELEASE | BUPROPION HYDROCHLORIDE | Prescription | AB3 | ||
| 201567-002 | BUPROPION HYDROCHLORIDE | TABLET, EXTENDED RELEASE | BUPROPION HYDROCHLORIDE | Prescription | AB3 |
Therapeutic equivalence
Source: Orange BookWhat this rating means: Therapeutically equivalent — bioequivalence demonstrated by in vivo or in vitro testing
Codes beginning with “A” indicate products the FDA considers therapeutically equivalent. Codes beginning with “B” indicate bioequivalence has not been established. See methodology.
Approval history
Source: Drugs@FDA| Type | No. | Action | Status | Date | Review |
|---|---|---|---|---|---|
| Supplement | 16 | Labeling | Approved | March 6, 2025 | Standard |
| Supplement | 15 | Labeling | Approved | December 13, 2022 | Standard |
| Supplement | 14 | Labeling | Approved | December 13, 2022 | Standard |
| Supplement | 13 | Labeling | Approved | March 5, 2020 | Standard |
| Supplement | 11 | Labeling | Approved | July 23, 2018 | Standard |
| Supplement | 10 | Labeling | Approved | July 23, 2018 | Standard |
| Supplement | 9 | Labeling | Approved | July 23, 2018 | Standard |
| Supplement | 5 | Labeling | Approved | November 10, 2015 | Standard |
| Supplement | 4 | Labeling | Approved | November 20, 2014 | Standard |
| Original application | 1 | Not Applicable | Approved | January 17, 2014 | — |
Prescribing information
Source: openFDA Drug LabelingReproduced verbatim from the Structured Product Labeling submitted to the FDA (effective 20240521). This is the manufacturer's labelling text, not a summary and not advice.
Boxed Warning
openFDA Drug LabelingWARNING: SUICIDAL THOUGHTS AND BEHAVIORS; AND NEUROPSYCHIATRIC REACTIONS See full prescribing information for complete boxed warning. • Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants. ( 5.1 ) • Monitor for worsening and emergence of suicidal thoughts and behaviors. ( 5.1 ) • Serious neuropsychiatric events have been reported in patients taking bupropion for smoking cessation. ( 5.2 ) WARNING: SUICIDAL THOUGHTS AND BEHAVIORS; NEUROPSYCHIATRIC REACTIONS SUICIDALITY AND ANTIDEPRESSANT DRUGS Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressants use in subjects aged 65 and older [see Warnings and Precautions ( 5.1 ) ] . In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. Advise families and caregivers of the need for close observation and communication with the prescriber [see Warnings and Precautions ( 5.1 ) ]. NEUROPSYCHIATRIC REACTIONS IN PATIENTS TAKING BUPROPION FOR SMOKING CESSATION Serious neuropsychiatric reactions have occurred in patients taking bupropion for smoking cessation [see Warnings and Precautions ( 5.2 ) ]. The majority of these reactions occurred during bupropion treatment, but some occurred in the context of discontinuing treatment. In many cases, a causal relationship to bupropion treatment is not certain, because depressed mood may be a symptom of nicotine withdrawal. However, some of the cases occurred in patients taking bupropion who continued to smoke. Although bupropion hydrochloride extended-release tablets (XL) are not approved for smoking cessation, observe all patients for neuropsychiatric reactions. Instruct the patient to contact a healthcare provider if such reactions occur [see Warnings and Precautions ( 5.2 ) ].
Recent Major Changes
openFDA Drug LabelingRECENT MAJOR CHANGES Boxed Warning 12/2014 Dosage and Administration ( 2.6 , 2.7 , 2.8 , 2.9 ) 12/2014 Contraindications ( 4 ) 12/2014 Warnings and Precautions ( 5.4 , 5.8 ) 12/2014
Indications and Usage
openFDA Drug Labeling1. INDICATIONS AND USAGE Bupropion hydrochloride extended-release tablets, USP (XL) is an aminoketone antidepressant, indicated for the treatment of major depressive disorder (MDD) and prevention of seasonal affective disorder (SAD). Periodically reevaluate long-term usefulness for the individual patient. ( 1 ) 1.1 Major Depressive Disorder Bupropion hydrochloride extended-release tablets, USP (XL) are indicated for the treatment of major depressive disorder (MDD), as defined by the Diagnostic and Statistical Manual (DSM). The efficacy of the immediate-release formulation of bupropion was established in two 4 week controlled inpatient trials and one 6 week controlled outpatient trial of adult patients with MDD. The efficacy of the sustained-release formulation of bupropion in the maintenance treatment of MDD was established in a long-term (up to 44 weeks), placebo-controlled trial in patients who had responded to bupropion in an 8 week study of acute treatment [see Clinical Studies ( 14.1 ) ]. 1.2 Seasonal Affective Disorder Bupropion hydrochloride extended-release tablets, USP (XL) are indicated for the prevention of seasonal major depressive episodes in patients with a diagnosis of seasonal affective disorder (SAD). The efficacy of bupropion hydrochloride extended-release tablets in the prevention of seasonal major depressive episodes was established in 3 placebo-controlled trials in adult outpatients with a history of MDD with an autumn-winter seasonal pattern as defined in the DSM [see Clinical Studies ( 14.2 ) ].
Dosage and Administration
openFDA Drug Labeling2. DOSAGE AND ADMINISTRATION General: • Increase dose gradually to reduce seizure risk. ( 2.1 , 5.3 ) • Periodically reassess the dose and need for maintenance treatment. ( 2.2 ) Major Depressive Disorder: • Starting dose: 150 mg/day once daily. Usual target dose: 300 mg once daily ( 2.2 ) • After 4 days, may increase the dose to 300 mg once daily. ( 2.2 ) Seasonal Affective Disorder: • Initiative treatment in the autumn prior to onset of seasonal depressive symptoms. ( 2.3 ) • Starting dose: 150 mg once daily. Usual target dose: 300 mg once daily. ( 2.3 ) • After one week, may increase the dose to 300 mg once daily. ( 2.3 ) • Continue treatment through the winter season. ( 2.3 ) Hepatic Impairmen t: • Moderate to severe hepatic impairment: 150 mg every other day ( 2.6 ) • Mild hepatic impairment: Consider reducing the dose and/or frequency of dosing. ( 2.6 , 8.7 ) Renal Impairment: • Consider reducing the dose and/or frequency of dosing. ( 2.7 , 8.6 ) 2.1 General Instructions for Use To minimize the risk of seizure, increase the dose gradually [see Warnings and Precautions ( 5.3 ) ]. Bupropion hydrochloride extended-release tablets (XL) should be swallowed whole and not crushed, divided, or chewed. Bupropion hydrochloride extended-release tablets (XL) should be administered in the morning and may be taken with or without food. 2.2 Dosage for Major Depressive Disorder (MDD) The recommended starting dose for MDD is 150 mg once daily in the morning. After 4 days of dosing, the dose may be increased to the target dose of 300 mg once daily in the morning. It is generally agreed that acute episodes of depression require several months or longer of antidepressant treatment beyond the response in the acute episode. It is unknown whether the bupropion hydrochloride extended-release tablets (XL) dose needed for maintenance treatment is identical to the dose that provided an initial response. Periodically reassess the need for maintenance treatment and the appropriate dose for such treatment. 2.3 Dosage for Seasonal Affective Disorder (SAD) The recommended starting dose for SAD is 150 mg once daily. After 7 days of dosing, the dose may be increased to the target dose of 300 mg once daily in the morning. Doses above 300 mg of bupropion hydrochloride extended-release were not assessed in the SAD trials. For the prevention of seasonal MDD episodes associated with SAD, initiate bupropion hydrochloride extended-release tablets (XL) in the autumn, prior to the onset of depressive symptoms. Continue treatment through the winter season. Taper and discontinue bupropion hydrochloride extended-release tablets (XL) in early spring. For patients treated with 300 mg per day, decrease the dose to 150 mg once daily before discontinuing bupropion hydrochloride extended-release tablets (XL). Individualize the timing of initiation and duration of treatment should be individualized, based on the patient's historical pattern of seasonal MDD episodes. 2.4 Switching Patients from Bupropion Hydrochloride Tablets or from Bupropion Hydrochloride Sustained-Release Tablets When switching patients from bupropion hydrochloride tablets to bupropion hydrochloride extended-release tablets (XL) or from bupropion hydrochloride sustained-release tablets to bupropion hydrochloride extended-release tablets (XL), give the same total daily dose when possible. 2.5 To Discontinue Bupropion Hydrochloride Extended-Release Tablets (XL), Taper the Dose When discontinuing treatment in patients treated with bupropion hydrochloride extended-release tablets (XL) 300 mg once daily, decrease the dose to 150 mg once daily prior to discontinuation. 2.6 Dosage Adjustment in Patients with Hepatic Impairment In patients with moderate to severe hepatic impairment (Child-Pugh score: 7 to 15), the maximum dose is 150 mg every other day. In patients with mild hepatic impairment (Child-Pugh score: 5 to 6), consider reducing the dose and/or frequency of dosing [see Use in Specific Populations ( 8.7 …
Dosage Forms and Strengths
openFDA Drug Labeling3 DOSAGE FORMS AND STRENGTHS • 100 mg – blue, round, biconvex, film-coated, extended-release (SR) tablets debossed with “S” on one side and “522” on the other. • 150 mg – purple, round, biconvex, film-coated, extended-release (SR) tablets debossed with “S” on one side and “525” on the other. • 200 mg –pink, round, biconvex, film-coated, extended-release (SR) tablets debossed with “S” on one side and “527” on the other. • Tablets: 100 mg, 150 mg, 200 mg. ( Error! Hyperlink reference not valid. )
Contraindications
openFDA Drug Labeling4 CONTRAINDICATIONS • Bupropion Hydrochloride Extended-release (SR) tablets are contraindicated in patients with a seizure disorder. • Bupropion Hydrochloride Extended-release (SR) tablets are contraindicated in patients with a current or prior diagnosis of bulimia or anorexia nervosa as a higher incidence of seizures was observed in such patients treated with the immediate-release formulation of bupropion [see Warnings and Precautions (5.3) ] . • Bupropion Hydrochloride Extended-release (SR) tablets are contraindicated in patients undergoing abrupt discontinuation of alcohol, benzodiazepines, barbiturates, and antiepileptic drugs [see Warnings and Precautions (5.3) , Drug Interactions (7.3) ] . • The use of MAOIs (intended to treat psychiatric disorders) concomitantly with Bupropion Hydrochloride Extended-release (SR) tablets or within 14 days of discontinuing treatment with Bupropion Hydrochloride Extended-release (SR) tablets is contraindicated. There is an increased risk of hypertensive reactions when Bupropion Hydrochloride Extended-release (SR) tablets are used concomitantly with MAOIs. The use of Bupropion Hydrochloride Extended-release (SR) tablets within 14 days of discontinuing treatment with an MAOI is also contraindicated. Starting Bupropion Hydrochloride Extended-release (SR) tablets in a patient treated with reversible MAOIs such as linezolid or intravenous methylene blue is contraindicated [see Dosage and Administration (2.4 , 2.5) , Warning and Precautions (5.4) , Drug Interactions (7.6) ]. • Bupropion Hydrochloride Extended-release (SR) tablets are contraindicated in patients with known hypersensitivity to bupropion or other ingredients of Bupropion Hydrochloride Extended-release (SR) tablets. Anaphylactoid/anaphylactic reactions and Stevens-Johnson syndrome have been reported [see Warnings and Precautions (5.8) ] . • Seizure disorder. ( Error! Hyperlink reference not valid. , 5.3 ) • Current or prior diagnosis of bulimia or anorexia nervosa. ( Error! Hyperlink reference not valid. , 5.3 ) • Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, antiepileptic drugs. ( Error! Hyperlink reference not valid. , 5.3 ) • Monoamine Oxidase Inhibitors (MAOIs): Do not use MAOIs intended to treat psychiatric disorders with Bupropion Hydrochloride Extended-release (SR) tablets or within 14 days of stopping treatment with Bupropion Hydrochloride Extended-release (SR) tablets. Do not use Bupropion Hydrochloride Extended-release (SR) tablets within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start Bupropion Hydrochloride Extended-release (SR) tablets in a patient who is being treated with linezolid or intravenous methylene blue. ( Error! Hyperlink reference not valid. , 7.6 ) • Known hypersensitivity to bupropion or other ingredients of Bupropion Hydrochloride Extended-release (SR) tablets. ( Error! Hyperlink reference not valid. , 5.8 )
Warnings and Cautions
openFDA Drug Labeling5. WARNINGS AND PRECAUTIONS • Seizure risk: The risk is dose-related. Can minimize risk by limiting daily dose to 450 mg and gradually increasing the dose. Discontinue if seizure occurs. ( 4 , 5.3 , 7.3 ) • Hypertension: Bupropion hydrochloride extended-release tablets (XL) can increase blood pressure. Monitor blood pressure before initiating treatment and periodically during treatment. ( 5.4 ) • Activation of mania/hypomania: Screen patients for bipolar disorder and monitor for these symptoms. ( 5.5 ) • Psychosis and other neuropsychiatric reactions: Instruct patients to contact a healthcare professional if such reactions occur. ( 5.6 ) • Angle Closure Glaucoma: Angle closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants. ( 5.7 ) 5.1 Suicidal Thoughts and Behaviors in Children, Adolescents, and Young Adults Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide. There has been a long-standing concern that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. Pooled analyses of short-term placebo-controlled trials of antidepressant drugs (SSRIs and others) show that these drugs increase the risk of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults (ages 18 to 24) with major depressive disorder (MDD) and other psychiatric disorders. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction with antidepressants compared to placebo in adults aged 65 and older. The pooled analyses of placebo-controlled trials in children and adolescents with MDD, obsessive compulsive disorder (OCD), or other psychiatric disorders included a total of 24 short-term trials of 9 antidepressant drugs in over 4400 patients. The pooled analyses of placebo-controlled trials in adults with MDD or other psychiatric disorders included a total of 295 short-term trials (median duration of 2 months) of 11 antidepressant drugs in over 77,000 patients. There was considerable variation in risk of suicidality among drugs, but a tendency toward an increase in the younger patients for almost all drugs studied. There were differences in absolute risk of suicidality across the different indications, with the highest incidence in MDD. The risk differences (drug vs. placebo), however, were relatively stable within age strata and across indications. These risk differences (drug-placebo difference in the number of cases of suicidality per 1000 patients treated) are provided in Table 1. Table 1Risk Differences in the Number of Suicidality Cases by Age Group in thePooled Placebo-Controlled Trials of Antidepressants in Pediatric and Adult Patients Age Range Drug-Placebo Difference in Number of Cases of Suicidality per 1000 Patients Treated Increases Compared to Placebo < 18 years 14 additional cases 18 to 24 years 5 additional cases Age Range Drug-Placebo Difference in Number of Cases of Suicidality per 1000 Patients Treated Decreases Compared to Placebo 25 to 64 years 1 fewer case ≥ 65 years 6 fewer cases No suicides occurred in any of the pediatric trials. There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide. It is unknown whether the suicidality risk extends to longer-term use, i.e., beyond several months. However, there is substantial evidence from placebo-controlled mainten …
Adverse Reactions
openFDA Drug Labeling6 ADVERSE REACTIONS The following adverse reactions are discussed in greater detail in other sections of the labeling: • Suicidal thoughts and behaviors in adolescents and young adults [see Error! Hyperlink reference not valid. , Warnings and Precautions (5.1) ] • Neuropsychiatric symptoms and suicide risk in smoking cessation treatment [see Error! Hyperlink reference not valid. , Warnings and Precautions (5.2) ] • Seizure [see Warnings and Precautions (5.3) ] • Hypertension [see Warnings and Precautions (5.4) ] • Activation of mania or hypomania [see Warnings and Precautions (5.5) ] • Psychosis and other neuropsychiatric reactions [see Warnings and Precautions (5.6) ] • Angle-closure glaucoma [see Warnings and Precautions (5.7) ] • Hypersensitivity reactions [see Warnings and Precautions (5.8) ] Most common adverse reactions (incidence ≥5% and ≥2% more than placebo rate) are: headache, dry mouth, nausea, insomnia, dizziness, pharyngitis, constipation, agitation, anxiety, abdominal pain, tinnitus, tremor, palpitation, myalgia, sweating, rash, and anorexia. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Solco Healthcare US, LLC at 1-866-257-2597 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice. Adverse Reactions Leading to Discontinuation of Treatment: In placebo-controlled clinical trials, 4%, 9%, and 11% of the placebo, 300-mg-per-day, and 400-mg-per-day groups, respectively, discontinued treatment due to adverse reactions. The specific adverse reactions leading to discontinuation in at least 1% of the 300-mg-per-day or 400-mg-per-day groups and at a rate at least twice the placebo rate are listed in Table 2. Table 2. Treatment Discontinuations Due to Adverse Reactions in Placebo-Controlled Trials Adverse Reaction Placebo (n=385) Bupropion Hydrochloride Extended-release (SR) tablets 300 mg/day (n=376) Bupropion Hydrochloride Extended-release (SR) tablets 400 mg/day (n=114) Rash 0.0% 2.4% 0.9% Nausea 0.3% 0.8% 1.8% Agitation 0.3% 0.3% 1.8% Migraine 0.3% 0.0% 1.8% Commonly Observed Adverse Reactions: Adverse reactions from Table 3 occurring in at least 5% of subjects treated with Bupropion Hydrochloride Extended-release (SR) tablets and at a rate at least twice the placebo rate are listed below for the 300- and 400-mg-per-day dose groups. Bupropion Hydrochloride Extended-release (SR) tablets 300 mg per day: Anorexia, dry mouth, rash, sweating, tinnitus, and tremor. Bupropion Hydrochloride Extended-release (SR) tablets 400 mg per day: Abdominal pain, agitation, anxiety, dizziness, dry mouth, insomnia, myalgia, nausea, palpitation, pharyngitis, sweating, tinnitus, and urinary frequency. Adverse reactions reported in placebo-controlled trials are presented in Table 3. Reported adverse reactions were classified using a COSTART-based Dictionary. Table 3. Adverse Reactions Reported by at Least 1% of Subjects and at a Greater Frequency than Placebo in Controlled Clinical Trials Body System/Adverse Reaction Bupropion Hydrochloride Extended-release (SR) tablets 300 mg/day (n = 376) Bupropion Hydrochloride Extended-release (SR) tablets 400 mg/day (n = 114) Placebo (n = 385) Body (General) Headache 26% 25% 23% Infection 8% 9% 6% Abdominal pain 3% 9% 2% Asthenia 2% 4% 2% Chest pain 3% 4% 1% Pain 2% 3% 2% Fever 1% 2% — Cardiovascular Palpitation 2% 6% 2% Flushing 1% 4% — Migraine 1% 4% 1% Hot flashes 1% 3% 1% Digestive Dry mouth 17% 24% 7% Nausea 13% 18% 8% Constipation 10% 5% 7% Diarrhea 5% 7% 6% Anorexia 5% 3% 2% Vomiting 4% 2% 2% Dysphagia 0% 2% 0% Musculoskeletal Myalgia 2% 6% 3% Arthralgia 1% 4% 1% Arthritis 0% 2% 0% Twitch 1% 2% — Nervous system Insomnia 11% 16% 6% Dizziness 7% 11% 5% Agitation 3% 9% 2% Anxiety 5% 6% 3% Tremo …
Drug Interactions
openFDA Drug Labeling7 DRUG INTERACTIONS • CYP2B6 inducers: Dose increase may be necessary if coadministered with CYP2B6 inducers (e.g., ritonavir, lopinavir, efavirenz, carbamazepine, phenobarbital, and phenytoin) based on clinical response, but should not exceed the maximum recommended dose. ( 7.1 ) • Drugs metabolized by CYP2D6: Bupropion inhibits CYP2D6 and can increase concentrations of: antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (e.g., haloperidol, risperidone, thioridazine), beta-blockers (e.g., metoprolol), and Type 1C antiarrhythmics (e.g., propafenone, flecainide). Consider dose reduction when using with bupropion. ( 7.2 ) • Drugs that lower seizure threshold: Dose Bupropion Hydrochloride Extended-release (SR) tablets with caution. ( 5.3 , 7.3 ) • Digoxin: May decrease plasma digoxin levels. Monitor digoxin levels. ( 7.2) • Dopaminergic drugs (levodopa and amantadine): CNS toxicity can occur when used concomitantly with Bupropion Hydrochloride Extended-release (SR) tablets. ( 7.4 ) • MAOIs: Increased risk of hypertensive reactions can occur when used concomitantly with Bupropion Hydrochloride Extended-release (SR) tablets. ( 7.6 ) • Drug-laboratory test interactions: Bupropion Hydrochloride Extended-release (SR) tablets can cause false-positive urine test results for amphetamines. ( 7.7 ) 7.1 Potential for Other Drugs to Affect Bupropion Hydrochloride Extended-release (SR) Tablets Bupropion is primarily metabolized to hydroxybupropion by CYP2B6. Therefore, the potential exists for drug interactions between Bupropion Hydrochloride Extended-release (SR) tablets and drugs that are inhibitors or inducers of CYP2B6. Inhibitors of CYP2B6: Ticlopidine and Clopidogrel: Concomitant treatment with these drugs can increase bupropion exposure but decrease hydroxybupropion exposure. Based on clinical response, dosage adjustment of Bupropion Hydrochloride Extended-release (SR) tablets may be necessary when coadministered with CYP2B6 inhibitors (e.g., ticlopidine or clopidogrel) [see Error! Hyperlink reference not valid. ] . Inducers of CYP2B6: Ritonavir, Lopinavir, and Efavirenz: Concomitant treatment with these drugs can decrease bupropion and hydroxybupropion exposure. Dosage increase of Bupropion Hydrochloride Extended-release (SR) tablets may be necessary when coadministered with ritonavir, lopinavir, or efavirenz [see Error! Hyperlink reference not valid. ] but should not exceed the maximum recommended dose. Carbamazepine, Phenobarbital, Phenytoin: While not systematically studied, these drugs may induce the metabolism of bupropion and may decrease bupropion exposure [see Error! Hyperlink reference not valid. ] . If bupropion is used concomitantly with a CYP inducer, it may be necessary to increase the dose of bupropion, but the maximum recommended dose should not be exceeded. 7.2 Potential for Bupropion Hydrochloride Extended-release (SR) Tablets to Affect Other Drugs Drugs Metabolized by CYP2D6: Bupropion and its metabolites (erythrohydrobupropion, threohydrobupropion, hydroxybupropion) are CYP2D6 inhibitors. Therefore, coadministration of Bupropion Hydrochloride Extended-release (SR) tablets with drugs that are metabolized by CYP2D6 can increase the exposures of drugs that are substrates of CYP2D6. Such drugs include certain antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, and sertraline), antipsychotics (e.g., haloperidol, risperidone, thioridazine), beta-blockers (e.g., metoprolol), and Type 1C antiarrhythmics (e.g., propafenone and flecainide). When used concomitantly with Bupropion Hydrochloride Extended-release (SR) tablets, it may be necessary to decrease the dose of these CYP2D6 substrates, particularly for drugs with a narrow therapeutic index. Drugs that require metabolic activation by CYP2D6 to be effective (e.g., tamoxifen) theoretically could have reduced efficacy when administered concomitantly wi …
Use in Specific Populations
openFDA Drug Labeling8 USE IN SPECIFIC POPULATIONS 8.1 Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or visiting online at https://womensmentalhealth.org/clinical-and-researchprograms/pregnancyregistry/antidepressants/. Risk Summary Data from epidemiological studies of pregnant women exposed to bupropion in the first trimester have not identified an increased risk of congenital malformations overall (see Data). There are risks to the mother associated with untreated depression (see Clinical Considerations). When bupropion was administered to pregnant rats during organogenesis, there was no evidence of fetal malformations at doses up to approximately 10 times the maximum recommended human dose (MRHD) of 450 mg/day. When given to pregnant rabbits during organogenesis, non-dose-related increases in incidence of fetal malformations and skeletal variations were observed at doses approximately equal to the MRHD and greater. Decreased fetal weights were seen at doses twice the MRHD and greater (see Animal Data) . The estimated background risk for major birth defects and miscarriage are unknown for the indicated population. All pregnancies have a background rate of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Disease-Associated Maternal and/or Embryo/Fetal Risk A prospective, longitudinal study followed 201 pregnant women with a history of major depressive disorder who were euthymic and taking antidepressants during pregnancy at the beginning of pregnancy. The women who discontinued antidepressants during pregnancy were more likely to experience a relapse of major depression than women who continued antidepressants. Consider the risks to the mother of untreated depression and potential effects on the fetus when discontinuing or changing treatment with antidepressant medications during pregnancy and postpartum. Data Human Data Data from the international bupropion Pregnancy Registry (675 first trimester exposures) and a retrospective cohort study using the United Healthcare database (1,213 first trimester exposures) did not show an increased risk for malformations overall. The Registry was not designed or powered to evaluate specific defects but suggested a possible increase in cardiac malformations. No increased risk for cardiovascular malformations overall has been observed after bupropion exposure during the first trimester. The prospectively observed rate of cardiovascular malformations in pregnancies with exposure to bupropion in the first trimester from the international Pregnancy Registry was 1.3% (9 cardiovascular malformations/675 first-trimester maternal bupropion exposures), which is similar to the background rate of cardiovascular malformations (approximately 1%). Data from the United Healthcare database, which has a limited number of exposed cases with cardiovascular malformations, and a case-controlled study (6,853 infants with cardiovascular malformations and 5,753 with non-cardiovascular malformations) from the National Birth Defects Prevention Study (NBDPS) did not show an increased risk for cardiovascular malformations overall after bupropion exposure during the first trimester. Study findings on bupropion exposure during the first trimester and risk left ventricular outflow tract obstruction (LVOTO) are inconsistent and do not allow conclusions regarding possible association. The United Healthcare database lacked sufficient power to evaluate this association; the NBDPS found increased risk for LVOTO (n = 10; adjusted odds ratio (OR) = 2.6; 95% CI 1.2, 5.7), and the Slone Epidemiology …
Mechanism of Action
openFDA Drug Labeling12.1 Mechanism of Action The mechanism of action of bupropion is unknown, as is the case with other antidepressants. However, it is presumed that this action is mediated by noradrenergic and/or dopaminergic mechanisms. Bupropion is a relatively weak inhibitor of the neuronal uptake of norepinephrine and dopamine, and does not inhibit monoamine oxidase or the re-uptake of serotonin.
Description
openFDA Drug Labeling11 DESCRIPTION Bupropion hydrochloride extended-release tablets, USP (XL) is an antidepressant of the aminoketone class, is chemically unrelated to tricyclic, tetracyclic, selective serotonin reuptake inhibitor, or other known antidepressant agents. Its structure closely resembles that of diethylpropion; it is related to phenylethylamines. It is designated as (±)-1-(3-chorophenyl)-2-[(1,1-dimethylethyl)amino]-1-propanone hydrochloride. The molecular weight is 276.2. The molecular formula is C 13 H 18 ClNO•HCl. Bupropion hydrochloride, USP powder is white, crystalline, and highly soluble in water, in 0.1 N hydrochloric acid, and in alcohol. It has a bitter taste and produces the sensation of local anesthesia on the oral mucosa. The structural formula is: Each bupropion hydrochloride extended-release tablets, USP (XL) intended for oral administration contains 150 mg or 300 mg of bupropion hydrochloride. In addition, each tablet contains the following inactive ingredients: ethyl cellulose, hypromellose, magnesium stearate, methacrylic acid copolymer dispersion, polyethylene glycol, povidone, silicon dioxide, triethyl citrate. The tablet is printed with black pharmaceutical ink which contains ammonium hydroxide, butyl alcohol, iron oxide black, isopropyl alcohol, propylene glycol and shellac. The insoluble shell of the extended-release tablet may remain intact during gastrointestinal transit and is eliminated in the feces. The Product meets USP Dissolution Test 26. Bupropion hydrochloride extended-release tablets, USP (XL)
Overdosage
openFDA Drug Labeling10 OVERDOSAGE 10.1 Human Overdose Experience Overdoses of up to 30 grams or more of bupropion have been reported. Seizure was reported in approximately one-third of all cases. Other serious reactions reported with overdoses of bupropion alone included hallucinations, loss of consciousness, sinus tachycardia, and ECG changes such as conduction disturbances (including QRS prolongation) or arrhythmias. Fever, muscle rigidity, rhabdomyolysis, hypotension, stupor, coma, and respiratory failure have been reported mainly when bupropion was part of multiple drug overdoses. Although most patients recovered without sequelae, deaths associated with overdoses of bupropion alone have been reported in patients ingesting large doses of the drug. Multiple uncontrolled seizures, bradycardia, cardiac failure, and cardiac arrest prior to death were reported in these patients. 10.2 Overdosage Management Consult a Certified Poison Control Center for up-to-date guidance and advice. Telephone numbers for certified poison control centers are listed in the Physicians' Desk Reference (PDR). Call 1-800-222-1222 or refer to www.poison.org. There are no known antidotes for bupropion. In case of an overdose, provide supportive care, including close medical supervision and monitoring. Consider the possibility of multiple drug overdose. Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. Induction of emesis is not recommended.
How Supplied / Storage and Handling
openFDA Drug Labeling16 HOW SUPPLIED/STORAGE AND HANDLING Bupropion Hydrochloride Extended-release Tablets USP (XL), 150 mg are creamy-white to pale-yellow, round, biconvex, beveled-edge coated-tablets imprinted with '353' in black ink on one side and plain on other side and are supplied as follows: NDC 68382-353-06 in bottle of 30 tablets with child-resistant closure NDC 68382-353-16 in bottle of 90 tablets with child-resistant closure NDC 68382-353-05 in bottle of 500 tablets NDC 68382-353-10 in bottle of 1000 tablets Bupropion Hydrochloride Extended-release Tablets USP (XL), 300 mg are creamy-white to pale-yellow, round, biconvex, coated-tablets imprinted with '354' in black ink on one side and plain on other side and are supplied as follows: NDC 68382-354-06 in bottle of 30 tablets with child-resistant closure NDC 68382-354-16 in bottle of 90 tablets with child-resistant closure NDC 68382-354-05 in bottle of 500 tablets NDC 68382-354-10 in bottle of 1000 tablets Storage Store at 20°C to 25°C (68°F to 77°F) [See USP Controlled Room Temperature]. Dispense in a tight, light-resistant container as defined in the USP. Bupropion Hydrochloride Extended-release Tablets USP (XL) may have an odor.
Adverse event reports
Source: openFDA FAERSAttributed to this product's most-reported active ingredient: BUPROPION HYDROCHLORIDE. Combination products with more than six active ingredients are not attributed, because a report count summed across a long ingredient list measures the list, not the medicine.
Recalls
Source: FDA Enforcement| Classification | Reported | Firm | Reason | Status |
|---|---|---|---|---|
| Class III | December 28, 2016 | Zydus Pharmaceuticals USA Inc | Failed Dissolution Specifications; 6 month time point | Terminated |
| Class III | November 30, 2016 | Zydus Pharmaceuticals USA Inc | Failed Dissolution Specifications: Product did not meet dissolution specification at an intermediate time point. | Terminated |
Packaging and NDCs
Source: NDC Directory| Package NDC | Product NDC | Labeler | Description | Marketing start |
|---|---|---|---|---|
| 71335-0801-1 | 71335-0801 | Bryant Ranch Prepack | 60 TABLET, EXTENDED RELEASE in 1 BOTTLE (71335-0801-1) | May 1, 2018 |
| 71335-0801-2 | 71335-0801 | Bryant Ranch Prepack | 180 TABLET, EXTENDED RELEASE in 1 BOTTLE (71335-0801-2) | August 9, 2024 |
| 71335-0801-3 | 71335-0801 | Bryant Ranch Prepack | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (71335-0801-3) | August 9, 2024 |
| 71335-0801-4 | 71335-0801 | Bryant Ranch Prepack | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (71335-0801-4) | August 9, 2024 |
| 71335-0801-5 | 71335-0801 | Bryant Ranch Prepack | 120 TABLET, EXTENDED RELEASE in 1 BOTTLE (71335-0801-5) | August 9, 2024 |
| 71335-0801-6 | 71335-0801 | Bryant Ranch Prepack | 28 TABLET, EXTENDED RELEASE in 1 BOTTLE (71335-0801-6) | August 9, 2024 |
| 63187-521-30 | 63187-521 | Proficient Rx LP | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (63187-521-30) | December 1, 2018 |
| 63187-521-60 | 63187-521 | Proficient Rx LP | 60 TABLET, EXTENDED RELEASE in 1 BOTTLE (63187-521-60) | December 1, 2018 |
| 63187-521-90 | 63187-521 | Proficient Rx LP | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (63187-521-90) | December 1, 2018 |
| 71205-565-30 | 71205-565 | Proficient Rx LP | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (71205-565-30) | May 11, 2021 |
| 71205-565-60 | 71205-565 | Proficient Rx LP | 60 TABLET, EXTENDED RELEASE in 1 BOTTLE (71205-565-60) | May 11, 2021 |
| 71205-565-90 | 71205-565 | Proficient Rx LP | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (71205-565-90) | May 11, 2021 |
| 65841-780-05 | 65841-780 | Zydus Lifesciences Limited | 500 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-780-05) | February 15, 2014 |
| 65841-780-06 | 65841-780 | Zydus Lifesciences Limited | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-780-06) | February 15, 2014 |
| 65841-780-10 | 65841-780 | Zydus Lifesciences Limited | 1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-780-10) | February 15, 2014 |
| 65841-780-16 | 65841-780 | Zydus Lifesciences Limited | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-780-16) | February 15, 2014 |
| 65841-836-05 | 65841-836 | Zydus Lifesciences Limited | 500 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-836-05) | August 2, 2018 |
| 65841-836-06 | 65841-836 | Zydus Lifesciences Limited | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-836-06) | August 2, 2018 |
| 65841-836-10 | 65841-836 | Zydus Lifesciences Limited | 1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-836-10) | August 2, 2018 |
| 65841-836-16 | 65841-836 | Zydus Lifesciences Limited | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (65841-836-16) | August 2, 2018 |
| 68382-353-05 | 68382-353 | Zydus Pharmaceuticals USA Inc. | 500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-05) | August 2, 2018 |
| 68382-353-06 | 68382-353 | Zydus Pharmaceuticals USA Inc. | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-06) | August 2, 2018 |
| 68382-353-10 | 68382-353 | Zydus Pharmaceuticals USA Inc. | 1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-10) | August 2, 2018 |
| 68382-353-16 | 68382-353 | Zydus Pharmaceuticals USA Inc. | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-353-16) | August 2, 2018 |
| 68382-354-05 | 68382-354 | Zydus Pharmaceuticals USA Inc. | 500 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-354-05) | February 15, 2014 |
| 68382-354-06 | 68382-354 | Zydus Pharmaceuticals USA Inc. | 30 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-354-06) | February 15, 2014 |
| 68382-354-10 | 68382-354 | Zydus Pharmaceuticals USA Inc. | 1000 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-354-10) | February 15, 2014 |
| 68382-354-16 | 68382-354 | Zydus Pharmaceuticals USA Inc. | 90 TABLET, EXTENDED RELEASE in 1 BOTTLE (68382-354-16) | February 15, 2014 |
| 71335-0801 | 71335-0801 | Bryant Ranch Prepack | — | November 1, 2014 |
| 63187-521 | 63187-521 | Proficient Rx LP | — | February 15, 2014 |
| 71205-565 | 71205-565 | Proficient Rx LP | — | November 1, 2014 |
| 65841-780 | 65841-780 | Zydus Lifesciences Limited | — | February 15, 2014 |
| 65841-836 | 65841-836 | Zydus Lifesciences Limited | — | August 2, 2018 |
| 68382-353 | 68382-353 | Zydus Pharmaceuticals USA Inc. | — | August 2, 2018 |
| 68382-354 | 68382-354 | Zydus Pharmaceuticals USA Inc. | — | February 15, 2014 |
Sources for this page
| Dataset | Agency | Used for |
|---|---|---|
| NDC Directory | FDA | Identity, ingredients, strengths, forms, routes, labelers, packages |
| Drugs@FDA | FDA | Application, sponsor, submissions, review documents, marketing status |
| Orange Book | FDA | Therapeutic equivalence codes, reference drug flags, patents, exclusivity |
| Drug Labeling | FDA / NLM | Prescribing information reproduced above |
| FAERS | FDA | Adverse event report counts |
| Enforcement | FDA | Recall records |
Generated September 25, 2026 · 12 sections on this page.